Because the GOP is ideologically opposed to price controls (except when it's in the form of subsidies to their state's pet industry of course). Something, something, free market distortions I think is the usual reason.
Democrats have some options they'd like to do that might help but cannot because of the filibuster. Reconciliation which is the only way around the filibuster guaranteed is pretty limited in scope due to the rules around it. Whether those could pass a vote if there was no filibuster is unknown because they all get completely blocked by Republican filibuster.
Which itself was a state level implementation of a program the insurance industry and national Republicans were talking up as an alternative in the 90s when, i the wake of the failure of Clinton’s healthcare reform, it seemed there was enough residual demand for something to be done in that regard nationally that they thought they needed to bring something to the table.
The bit about Manchin is fact, though. They can't change the rule without him, and he doesn't want to eliminate the filibuster. He did say that he would consider modifying it to make it more difficult, however.
He's being far more cooperative than, say, Liebermann was while passing the ACA, and his actual goal is to say he's fighting those out of control big city liberals by keeping the filibuster, but the changes he'll allow will make it completely different and more or less how it was in the 90s.
Sinema also wants to keep it and seems to actually be a true believer, which is dumb and not even what her voters want, so who knows what's up with that.
I don't think we can be too charitable towards Manchin considering his other stances. That said, you raise a good point: changing the filibuster doesn't really change his position; he's still an essential vote to pass any legislation in a tied senate, so he benefits from either outcome. I suppose, all other things being equal, it makes sense for him to nominally oppose ending the filibuster for the sake of his base.
With two parties both jockey for position in being as close to center as possible while still appearing unique. To leave the center is to sacrifice those voters to the opposition. This is why first past the post voting is stable yet nearly useless.
Democrats consist of actual liberals, marxists, authoritatians, etc.
Republicans consist of actual fiscal conservatives, the religious, libertarians, etc.
Both are unhappy alliances and occasionally fracture and spill one of these constituencies and the opposition rushes to appeal to them.
Harry Reid previously lowered cloture threshold for non SCOTUS appointments, but only after Republicans act(ed) in bad faith and refused to "Advice and Consent."
They refused to confirm 2 very important seats for 'cost savings' and claimed that the DC circuit was 'underworked.' This is in the context of anti-Obama everything and no matter how milquetoast the nominee was.
https://en.wikipedia.org/wiki/Nuclear_option#Use_in_2013_and...
That very power is a reason I think there's a few hold outs on the Democrat side that don't want to get rid of it. The senate is naturally stacked against the democrats as the parties are currently aligned so a few don't want to risk giving up that power. There's also a number who (at least claim to) believe that the unlimited debate is an important part of the Senate.
Personally I think it's a relic that's getting in the way of passing the exact legislation that will make Democrats more popular (and make it easier to vote to counteract some extremely blatant voter suppression happening in red states).
[0] consider 3 senators working 8 hour shifts of 8 on 16 off. That would be maintainable for a very long time.
I think a government where the majority party can't actually implement any kind of agenda is a fundamentally broken government.
> I dont understand why states have to wait around for the federal government to solve healthcare.
Because they're ironically forbidden by federal law. Several legislators in CA would love to bring a statewide single-payer healthcare bill forward, but funding it would require using federal Medicare dollars in ways that require permission from the US Congress. Guess how likely that'll be forthcoming?
I think this is a big sustaining source of disillusion with the US government. Cynical minorities have a pretty easy way to make people hate the opposition by just blocking everything, this was even explicitly acknowledged by McConnel as their strategy. Block everything no matter how small.
Now, it’s also possible that we’re suffering from the two party hell we’ve created and that we have an overstated (too large) minority party that doesn't reflect the wishes of any reasonable fraction of our people... I tend to think this is more of a problem than people realize. We need voting reform to bring more plurality into govt operations and lawmaking.
Republican Senators don't seem to care if an agenda is supported by a majority of registered Republican voters.
Anyhow, the Senate must be reformed or abolished. Land does not require representation. Give every state a guaranteed 2 senators, I suppose, but some reasonable formula should be implemented that apportions more populous states additional senators.
The power of the minority was a crappy compromise to get the less densely populated states (not coincidentally southern slave owning states) to sign on to the constitution. The original Articles of Confederation were even worse requiring basically unanimity to pass federal laws and taxes. The whole job of the Senate was to appease those same states. Do any other countries have this kind of explicit carve out for land (essentially) getting an equal weight?
Repetitively, issues are raised and forgotten by politicians, and never actually solved by the party in power. For various reasons, many people have come to believe propaganda about the filibuster. For example, Sen. Warren and others say that the filibuster is racist and a relic of the past, yet Democrats (including Warren) filibustered the Republican's $500 billion coronavirus relief bill in September of last year. They were really saving their votes to send you money after the election. They also filibustered a Republican police-reform bill last year.
While the parties do not necessarily hold the same platforms as each other, many of the Senators literally went to school in order to become politicians. They are not your friends. They are prevaricating in order to remain in power and make money. Not all - but many of them. Warren has some redeeming qualities, but facts are facts. She has been a Senator since 2013 and has had her own share of "clarified statements".
Definition: A wedge issue is a divisive political issue, especially one that is raised by a candidate for public office in hopes of attracting or alienating an opponent's supporters.
These wedge issues are used to keep people's emotions going, so as to vote for one party and hate the other. Then, the issues are not solved a the times they could. There is a reason for the existence of an actual term, wedge issue, for the concept - because it constantly happens.
Sure, that is still pretty high, but it basically saved my life. If not for Obamacare I would need to come up with over 300k per year to not get very sick.
This isn't an either party is the same situation. One party would let me be seriously ill. One would give me a possible solution.
I am on an orphan drug myself (subcutaneous immunoglobulin, which I am self-infusing at the moment...) which costed $278,000/year under contract, when I lived in the US. Of course the provider bills a much higher amount. But the figure I gave is the one that is paid out, over the course of a year.
You should know that the third leading cause of death in the US is believed to be preventable medical errors. This has been corroborated via multiple follow-up studies, just google "third leading cause of death US medical errors". But, here is the original article: https://www.bmj.com/content/353/bmj.i2139
You can go to the "best hospitals", have the "best insurance", and "be able to pay for care", but you cannot evade a statistic like that. The medical error rate is on par with developing countries, by the way.
Also, 7-8% of the general population collectively has some sort of rare disease, which is theoretically treated by orphan drugs. There are now orphan drugs that cost $2 million/year per person, and the cost is so extortionate that it is literally going to screw over the US health system. Such meds have to be taken for life.: https://www.nytimes.com/2019/08/25/health/drug-prices-rare-d...
Also, life expectancy does not look so good in the US.
How healthy will we be in 2040? http://www.healthdata.org/news-release/how-healthy-will-we-b...
US was 43rd worldwide in life expectancy in 2016. In 2040, we are expected to be 64th.
Honestly, this kind of stuff is why I emigrated and I am a dual US|EU (Croatian) citizen. As an EU citizen, I have Freedom of Movement rights to live/work/retire in 30+ countries within the EU and EFTA (minus Liechtenstein--has an immigration quota).
Because of your health status, Canada, Australia, and New Zealand are off limits because they have strict medical inadmissability clauses in their immigration laws. I would stay away from the UK too, because they could implement such rules post-Brexit.
But, I have studied healthcare systems, logistics of healthcare, along with rules for acquiring citizenship, for hundreds of hours. If you want any help or advice, feel free to shoot me an email (check my profile).
Partisan gridlock is terrible, but it's even worse when the parties agree...
There are some work arounds but they're limited to things that one person decides are sufficiently budget related enough to go through the reconciliation process that prevents filibusters. And that is a thrice a year option at most.
[0] I get why since senators have all sorts of commitments to their time even counting just Senate business but it means a there's basically no cost to doing one where there was.